As model for health care, military medicine sets a proud example

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Why is military medicine a unique form of health care?

The recent passage of the health-care reform bill is sure to spark debate about the merits of government-run medicine. As a current provider in the military health-care system, I believe there are several lessons to be learned from this "government-run" option. I have some experience in civilian models as well, with which to compare my military service.

PROPONENTS OF THE current legislation see this reform as necessary, and on that point I have no disagreement. I am not certain, however, what the correct model is, nor do I have the confidence that anyone in Washington does, either. I might feel differently if someone could actually explain exactly what the plan entails or how it proposes to solve the country's health-care woes.

Opponents of the legislation have and will continue to use various arguments related to "big government" and "socialized medicine" as this plan's shortcomings. Inherent in this argument is the supposition that military medicine represents a form of socialized medicine. How does one define socialized medicine? In simplest terms, it's a central government-funded and managed organization that incorporates salaried providers and protocols for access and services rendered.

The Army Medical Department is centrally funded through the U.S. government, and all providers are salaried without performance bonuses. There are however, no mandates or protocols which dictate the care any individual provider will perform, other than standard medical practice and the Hippocratic Oath. This is the primary difference between military medicine and the current practices of Canada and Great Britain.

Does this make the military medicine system better? In a word: Yes.

Medicine always will remain an art and a science, and should be practiced without third-party constraints. The physician has an obligation to his individual patient to evaluate and treat as clinically indicated. This model does not lend itself to generalized protocols, which are created with the whole rather than the individual in mind.

HOW DOES MILITARY medicine compare to civilian practice in the United States? This is a difficult comparison because of the fact that there is no single business model in the private sector, but they generally have the insurance industry in common. Health maintenance organizations remain a prominent player in the private model.

Military medicine can be viewed as an HMO, but I submit there is a key difference. Physicians who practice in the military system are rated based on their ability to provide quality care and not on the amount of money spent per patient on laboratory tests, radiologic studies or prescriptions. This does not mean that providers operate on the premise of a blank check and order various tests simply because they are available.

The training and education of resident physicians and overall practice of medicine in the Army Medical Department is done responsibly; i.e., in the spirit of Hippocrates and William Osler, the renowned clinician from the 19th century. I do not mean to imply that the private sector practices irresponsibly -- rather, that medicine in this sector is practiced with an eye on the bottom line. This includes administrators watching the balance sheet and potentially dictating the types of services that can be offered for certain conditions.

I BELIEVE THAT the practice of medicine in the military is pure, meaning it most closely resembles the ideals of Hippocrates and Osler. In addition, the care is provided over the long term by those of us who choose to function in this system out of duty, honor, and respect for current and past service men and women and their families.

I do not believe that this model is the answer for the entire country. I am simply proud to be a part of a system that works.

(The writer -- a U.S. Army major -- is on the consulting staff of the Division of Pulmonary, Critical Care and Sleep Medicine within the Department of Internal Medicine at Dwight D. Eisenhower Army Medical Center in Augusta.)

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johnston.cliff
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johnston.cliff 04/17/10 - 04:24 am
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Within the very narrow

Within the very narrow parameters laid down by the major, socialized medicine can be beneficial. However, in real life that's not the case. The medical treatment to the military is a benefit of their service., it's not a subsidy benefit. It's been paid for with blood, body parts and lives. The obamacare obamanation is all about bringing America to its knees and ruling the dumb masses as the elite sees fit. The vast majority of Americans say, " NO THANKS !!!" and will say it again in November.

deekster
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deekster 04/17/10 - 06:07 am
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Some how in all of this

Some how in all of this debate on "health care", has been the premise that it involves "medial care". Two different issues. Obamacare has little to do with "medical care". Must less the improvement or cost reduction of same. Sheeple want everything for free. Obamacare appeals to the "freeloaders". They want Bill Gates Benefits without the Bill Gates "work and work ethic". Military medicine is basic. Military doctors are "freer" to experiment on patient with different drugs and methods. Military doctors are exempt from malpractice lawsuits. Military doctors do not practice "defensive medicine", as with private doctors. Private doctors view patients as adversaries first. Patients looking for lawsuits, multiple drug prescription and those of the hypochondriac persuasion. After they "sift through you motives", hopefully they can treat your illness.

deekster
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deekster 04/17/10 - 06:12 am
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When the major talks about

When the major talks about "pure medicine", he is talking about "healing the patient". Private doctors are more concerned with there "bottom line" than any "individual patient". Mega Clinics have become "assembly line medical facilities doling out "cookie cutter diagnoses" and treatment. The individual patient is lost amidst "medical corporate business at the local general practitioner. Five minutes of care.

Tigger_The_Tiger
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Tigger_The_Tiger 04/17/10 - 07:24 am
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Not to mention that while in

Not to mention that while in the military, I was repeatedly denied care of a doctor and given care by a corpsman instead, because there weren't enough doctors (rationing). It happens every time you have more patients than the doctors can handle.

Tigger_The_Tiger
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Tigger_The_Tiger 04/17/10 - 07:28 am
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So deekster...when you cut

So deekster...when you cut the pay of the doctor, and force him to provide care for all, you assume he will give more attention to the "individual patient?" I don't see it.

Whyisit01
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Whyisit01 04/17/10 - 08:26 am
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Vast majority of American

Vast majority of American LOL... must be ONLY those on the right. EVERY republican says that LOL.

Tigger_The_Tiger
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Tigger_The_Tiger 04/17/10 - 08:29 am
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No, Whyisit...........nearly

No, Whyisit...........nearly every poll conducted says a vast majority of American's are against Obamacare.

Ayetidiosi
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Ayetidiosi 04/17/10 - 08:36 am
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Despite what Jack wants, this

Despite what Jack wants, this story deals with a great testimony from a Military Professional. Look at this line: I do not believe that this model is the answer for the entire country. I am simply proud to be a part of a system that works.
It is my opinion the supporters of Obamacare only support it for the same reasons it HAD to be done now: Obama's legacy. Had to have SOMETHING to answer: "What has he done?" without resorting to baseless personal attack.
They will learn right quickly something is often far worse than nothing at all.

Rhetor
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Rhetor 04/17/10 - 09:03 am
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Throughout this debate, the

Throughout this debate, the conservatives have consistently mis-represented the Democrats' health care reform. Under the new law, doctors and hospitals continue to be independent. The government is not buying hospitals or hiring doctors. Nor is it a gift to freeloaders, for the core of the plan is to make it possible for ordinary people who do not work for a large company to buy health insurance at group rates. The plan also taxes those irresponsible people who refuse to do so, which is only reasonable since they will eventually land in the hospital at (enormous) public expense. It is not sending them to jail. It is a market-based solution that takes advantage of free enterprise. It is true that many Democrats wanted socialized medicine on the British model, or socialized insurance on the Canadian model, but such a provision is not in any way a part of the law that was actually passed. The plan includes no death panels (it never did) and no provision to help illegal aliens, who cannot buy insurance under the plan even at their own expense. The conservative media's failure to explain the plan accurately is even more shameful than their usual falsehoods and distortions.

Ayetidiosi
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Ayetidiosi 04/17/10 - 09:14 am
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Rhet: The FACT the new law

Rhet: The FACT the new law mandates profit margin for insurance industry, combined with the FACT the new law mandates coverage for pre-existing conditions, combined with the FACT you can stop buying health insurance (reducing income to the industry) and pay Uncle Sam instead, will guarantee the failure of the private insurance industry. Anything in this law referring to "private insurers" is window dressing and moot.

Any industry forced to operate under those conditions must fail, for they cannot print money.

dichotomy
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dichotomy 04/17/10 - 10:52 am
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Many say the Republicans

Many say the Republicans failed to explain the benefits of Obamacare. I say the Democrats have lied about the true cost of Obamacare, it's impact on the medical establishment, and the fact that it is engineered to bankrupt private insurers or drive their premiums so high that everyone wil be forced to the government "pool", commonly referred to as the government takeover plan. The 85% of the people who had good insurance will soon see premiums that they, and their employer, cannot possibly pay and they will be thrown into the "pool" or dumped into Medicaid. Social engineering through taxation and government mandates. Communism, you've gotta love it. No, I'm serious. Obama, Pelosi, and Reid say that you've "gotta" love it whether you want to or not. As leaders of the Politburo they have decided what is best for you and your family and you've gotta love it or they will send out the KGB...I mean IRS. And don't worry. They won't put you in jail......UNLESS YOU DON'T PAY.

Ayetidiosi
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Ayetidiosi 04/17/10 - 11:58 am
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They won't put you in

They won't put you in jail......UNLESS YOU DON'T PAY.
________________________
It's worse than that: if you don't pay, they WON'T do a damn thing to you! It'd be hilarious, if it weren't so sad.

Ayetidiosi
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Ayetidiosi 04/17/10 - 12:39 pm
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Check this out: Fifteen years

Check this out:

    Fifteen years after the Oklahoma City bombing, the specter of domestic terrorism has returned to haunt the Obama administration, with a warning from the FBI that “home-grown and lone-wolf extremists” now represent as serious a threat as Al Qaeda and its affiliates, The Times reported on Saturday.
    An FBI spokesman said Friday that Mueller was referring to right-wing extremist groups and anti-government militias, as well as American Islamists, in his testimony to the Senate committee that must approve the FBI’s $8.3 billion budget
    “It’s one thing to express dissatisfaction with the Government but once you cross the line with a violent threat, that’s a violation that we take extremely seriously,” Bill Carter, the bureau’s spokesman, said.

Summary for you late arrivals: Which segment of society is most likely to suffer the toothless penalties of the health insurance law?

Which segment of society is most likely to suffer unlawful search and seizure if alleged to be a "right-wing extremist"?

Can you say "tan tax"?

    Ayetidiosi advocates the NON-violent change of the Federal Government of the USA and in no way, shape or form calls for any violent action for or against the current regime of same.

Riverman1
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Riverman1 04/17/10 - 03:37 pm
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I'll only point out that

I'll only point out that President Obama previously said the health care bill is only the FIRST STEP. It will continue to move toward a one payer system and that means the government runs it.

corgimom
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corgimom 04/17/10 - 06:16 pm
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I'm all for non-violent

I'm all for non-violent change in the US, too. It's called "voting".

Tess Teckles
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Tess Teckles 04/17/10 - 06:20 pm
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Tess Teckles thinks that it

Tess Teckles thinks that it is Very annoying to speak of oneself in the third person. Tess Teckles also thinks that it is Unconstitutional and will surely lead to Socialism. Tess Teckles blames Obama!

Kitten35
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Kitten35 04/23/10 - 02:58 pm
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Do you people know what it

Do you people know what it actually contains, or just the hype and propaganda about it?

Most of the rest of world has been operating on this system for years, and most of the rest of the world is not communist either. It's time to educate yourself on the meaning of "communism" and the way our government works. This is not the end of the world.

Kitten35
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Kitten35 04/23/10 - 02:59 pm
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duplicate

duplicate

brayton99
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brayton99 04/27/10 - 02:14 am
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the military leaves hundreds

the military leaves hundreds of injured former servants with no funding, no health care, no support, no chance to live a normal life, this is the example we should hug up to? I THINK NOT!!!!!

Trey Enfantay
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Trey Enfantay 04/27/10 - 02:26 am
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